SciELO - Scientific Electronic Library Online

vol.29Programas de estímulo à criatividade em escolas: uma revisão sistemática índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados




Linhas Críticas

versão impressa ISSN 1516-4896versão On-line ISSN 1981-0431

Linhas Críticas vol.29  Brasília  2023  Epub 08-Maio-2023 


Working conditions in technical schools and training of health workers

Adriana Katia Corrêa1

Maria José Clapis2

Rosana Aparecida Pereira3

1PhD in Nursing from the University of São Paulo (2000). Associate Professor at the Ribeirão Preto College of Nursing, University of São Paulo.

2PhD in Nursing from the University of São Paulo (1997). Senior Professor at the Ribeirão Preto College of Nursing, University of São Paulo.

3PhD in Health Sciences from the Ribeirão Preto College of Nursing, University of São Paulo (2022). Leader of the Institute for Healthcare Improvement Open School Chapter at the Ribeirão Preto College of Nursing, University of São Paulo.


This article aims to present an analysis regarding the working conditions aspects in institutions that offer technical courses in the healthcare field in the state of São Paulo and their relationships with the training of workers. It is a qualitative, dialectical, and historical study involving ten schools. Despite the regulated situations, there is the insecurity of working relationships; contracts as instructors; division of work between theory and practice teachers, according to employment relationships. The facilities and material resources, in general, respond to the requirements. The commitments of most of the schools are primarily to the maintenance of social relationships of the capitalist mode of production.

Keywords Professional Education; Education; Working Conditions; Faculty; Health


O objetivo é apresentar uma análise acerca de aspectos das condições de trabalho em instituições que ofertam cursos técnicos da área da saúde no estado de São Paulo e suas relações com a formação dos trabalhadores. Estudo qualitativo, histórico-dialético, envolvendo 10 escolas. Apesar de situações regulamentadas, há precarização das relações de trabalho; contrato como monitores; divisão do trabalho entre professores da teoria e da prática, conforme vínculos empregatícios. A estrutura física e os recursos materiais, no geral, respondem às normativas. Predominam compromissos da maioria das escolas com a manutenção das relações sociais do modo de produção capitalista.

Palavras-chave Educação Profissional; Educação; Condições de trabalho; Docentes; Saúde


El objetivo es presentar un análisis acerca de aspectos de las condiciones de trabajo en instituciones que ofertan cursos técnicos del área de la salud en el estado de São Paulo y sus relaciones con la formación de los trabajadores. Estudio cualitativo, histórico-dialéctico, involucrando 10 escuelas. A pesar de situaciones reguladas, hay precarización de las relaciones de trabajo; contrato como monitores; división del trabajo entre profesores de la teoría y de la práctica, conforme vínculos empleadores. La estructura física y recursos materiales, en general, responden a las normativas. Predominan compromisos de la mayoría de las escuelas con la manuntención de las relaciones sociales del modo de produción capitalista.

Palabras clave Educación Profesional; Educación; Condiciones de Trabajo; Docentes; Salud


The technical courses that make up the environment and health axis, provided for in the Brazilian National Technical Courses Catalogue (Brazil, 2020 a), represent a prominent position in the number of enrollments in Technical and Vocational Education and Training integrated into High School (EPTNM), an upper secondary education modality. This axis accounts for 29.35% of total enrollments in this type of education. Nursing enrollment corresponds to 62.68% of the total number of technical courses in the health area (Brazil, 2020 b). Technical courses form the majority of workers who provide health care to the population, with an emphasis on nursing. In Brazil, nursing workers represent around 70.2%, while physicians occupy 15.7%, dentists 9.0%, and pharmacists 4.9% (Pan American Health Organization [PAHO], 2021 ).

Despite these workers’ representativeness, the challenges are numerous concerning their training. EPTNM in the health area is part of the Brazilian history of technical and vocational education. The welfare, disciplining origins, and structural duality are remarkable (Romanelli, 2012 ; Caires & Oliveira, 2016 ), which is related to the separation between manual work and intellectual work, the former being subject to prejudices that are associated, among other aspects, with fragile conditions of the formative processes, including the formation and working conditions of teachers. It is also worth considering that EPTNM in the health area was first offered by a private network (Wermelinger et al., 2020 ). This situation calls into question the contradiction between training workers to work in a professional field that needs to focus on social needs, highlighting the importance that technicians have in strengthening the Health Unic System (SUS) as a public policy and strict compliance with the logic of the market.

This contradiction has been intensifying as, since the 1990s, in Brazil, educational policies, including those that direct the EPTNM, are based on the premises of neoliberal ideas. Changes in productive processes and social relations in the world of work, in the context of the expansion of the capitalist mode of production, with the internationalization of capital and the reordering of the role of the State, weaken social policies in peripheral countries, leading to essential privatizing measures in the neoliberal model. EPTNM policies are based on these issues.

These are questions that need to be known and analyzed by professors, since, dialectically, despite being subsumed under capital, their work is strategic for strengthening a counter-hegemonic notion (Moura, 2014 ). Thus, training projects are put into action by concrete subjects in real schools that are part of a political, economic, and social scenario, involving, among other dimensions, working conditions:

It starts with the concept of working conditions in general, present in Marx's work that deals with the work process. The notion of working conditions designates the set of resources that make it possible to conduct the work, involving the physical installations, the materials, and inputs available, the equipment and means of conducting the activities, and other types of support needed, depending on the nature of the production. However, working conditions are not restricted to the plan of the post or workplace or to conducting the work process itself […] it also concerns employment relations. Working conditions refer to a set that includes relationships that relate to the work process and employment conditions (forms of hiring, remuneration, career, and stability). The relevance of discussing the theme is based on knowledge of the effects of the conditions in which workers conduct their activities on themselves and the desired results. (Oliveira, 2010 , n.p.)

This study is based on the following questions: how are the working conditions involving teachers in schools that offer technical courses in the health area in the state of São Paulo? What are its implications for the training process of workers? This text aims to present an analysis of aspects of working conditions in some institutions that offer technical courses in the health area in the state of São Paulo and their relationship with the training of workers at EPTNM.


This article is the result of a Regular Fapesp Project – n.º 2019/06374-6, whose general focus is the training of technical health workers in the state of São Paulo. It is a qualitative study from a historical-dialectical perspective, involving field research, with visits to teaching units and semi-structured interviews (Cellard, 2012 ) with managers (course coordinators, school directors, or technical managers, according to the administrative structure of each institution) and teachers. These visits and interviews were conducted by the researcher in charge in 2022. The interviews with managers were face-to-face and with teachers, except for one, which took place remotely on a platform. Only one of the course coordinators did not allow recording. The managers also answered, before the interviews, a structured online questionnaire to obtain data on the general characterization of the course, with the function of being a trigger for the interviews, as well as supporting the delimitation of formal data characterizing the course, including information related to working conditions, the focus of this study.

Ten schools were involved, five public and five private, included based on the following criterion: in the last five years (considering the initial year of research development in 2020), had at least one of the courses that are among the most offered and which have the highest number of enrollments in the state: nursing, radiology, pharmacy, nutrition, and dietetics (Corrêa et al., 2022 ). Schools belonging to the State Technical Schools (ETECs) – Centro Paula Souza and the Network of Technical Schools of the Health Unic System (ETSUS), National Service for Commercial Learning (Senac), and other private schools, covering the capital and the countryside, participated. The following were included: technical courses in nursing at ten schools, technical courses in radiology at two private schools, technical courses in nutrition and dietetics at a public school and a private institution, and one technical course in pharmacy at a private institution.

Contact was made with management or a representative body from each school to present the proposal for this study and a formal invitation. Then, the course coordinators were contacted, according to the administrative structure, direction, area coordinator, and technical person in charge. Upon acceptance, the course plans (which contain the political-pedagogical project), the school regiment, and other documents considered relevant by the manager were requested. While analyzing the documentation, the online questionnaire was sent to the designated manager at each school.

Visits to the schools happened in 2022, and the interview with the managers occurred on the same day. The data from the online questionnaires were already analyzed and helped deepen the questions and clarify points incorporated into the already elaborated script. The visits followed a guiding script regarding the physical structure and resources, which were also explored in the interviews. Data from the visits were systematized descriptively and linked to excerpts from the interviews that referred to the structural conditions of the schools. The interviews were fully transcribed, and then the content analysis was performed (Bardin, 2016 ). The dataset was related to teaching working conditions as a fundamental category, considering the scenario of the world of work in schools that offer technical courses in health, in the political, economic, and social context marked by capitalist production relations, based on neoliberal ideas. It presupposes privileging the categories of mediation, contradiction, and totality (Kosic, 1976 ). Some relationships were made between working conditions, the focus of this article, and the training of technical workers distanced from an emancipatory perspective.

Considering the questionnaire phases and the interviews, 23 managers participated (10 from the private sector and 13 from the public sector), and 23 teachers were interviewed (13 from the public sector and ten from the private sector). Among the managers, the majority consisted of nurses, a total of 14, also with the participation of a social worker, two nutritionists, a pharmacist, two radiology technologists (one of them also with a degree in physical education), and three others with their initial formation in other areas than health, but with specialization courses or master's degrees in the area. Only one of the coordinators has no training in the health area. As for the teachers, in addition to 18 nurses, a psychologist, two pharmacists, a nutritionist, and a pedagogue participated. The priority participation of nurses occurs because this is the course with the highest offer and enrollments. These employees worked for different periods, ranging from six months to 24 years. This study was approved by the Research Ethics Committee of the University of São Paulo at the School of Nursing of Ribeirão Preto.

General aspects regarding the technical courses

The course offering predominates at night, with the priority presence of working students. The course offering is wider in private institutions, reaching 12 classes with 400 students in one of the schools. Internships are mandatory in technical courses in nursing and radiology and optional in courses in pharmacy and nutrition, and dietetics.

The working conditions

In public schools, the managers’ employment relationships were: eight public employees, whose regime is governed by the Consolidation of Labor Laws (CLT), two statutory civil servants, two with commissioned positions, and one without a formal employment relationship that worked in ETSUS. In private schools, there are ten professionals with CLT. Of the managers, seven work elsewhere - health services, technical and higher education institutions, or work in the same network at another school unit. A coordinator from the private sector is retired, having also worked in a health service at the same time as the school. Another from a public school, as soon as she answered the questionnaire, retired.

As for the teachers interviewed, of the ten in the private network, six have a CLT contract with an indefinite period, and four work without a formal employment contract, being paid per hour/class. As for the 13 in the public network, six have a CLT public employee relation with an indefinite contract, three with the same situation, however, with a fixed-term contract, and four without a formal work relation (hour/class).

In the public schools that are part of the Centro Paula Souza, there is a formal employment relationship as a CLT public employee, with institutional entry through a public examination or selection process, with an indefinite period, and others with a determined period, which was only highlighted in the interviews. ETSUS also has a temporary contract as a service provider without formal employment relationship – payment per hour/class, with appointment by selection process or invitation. In private institutions, a CLT contract, a temporary contract as a service provider, and a temporary contract without a formal employment relationship are indicated – payment per hour/class. One of the managers in the private network only mentioned the invitation to teachers without any form of contract. It was possible to apprehend that some private schools have a leaner permanent staff working mainly in the classroom, with a CLT contract, and several professionals who supervise internships, with a precarious formal employment relationship.

In the private sector, three teachers have another job, two are retired from the health service, and the other two teachers have an educational company or provide private care services. In the public sector, two teachers have a CLT contract for an indefinite period, and two teachers with a CLT fixed-term contract also work in another location. Another teacher, a CLT teacher with an indefinite contract, is a partner in a private health company, and three others from ETSUS also have two jobs. Two public school teachers are retired from health services. The chart below summarizes these aspects.

Source: the authors.

Chart 1  Aspects of the working conditions of the participating managers and teachers 

From the interviews, three themes were configured concerning working conditions (formal employment relations and other specificities). The first is divided into three subcategories, which show experiences and ways of dealing with working conditions by managers and teachers. They were identified as an interviewee (I), followed by the interview number, age in years, and profession.

Category 1 – Employment relationships and their weaknesses

Public institutions were also identified as a scenario marked by the precariousness of labor relations. Considering the non-completion of public examinations, the fixed-term contract is present. Some managers and professors also referred to the classification system adopted by the institution, which is decisive in assigning classes, revealing a policy that generates instability.

1a – Absence of public examinations and fixed-term contracts in public schools

I am indeterminate, but I am CLT [...] some teachers are hired for a determined period [...] Determined means that I have substitute classes [...] (Interviewee 2 – I2, 49, licensed nutritionist)

We had a public examination until 2000 [...], and it was for an indefinite period [...] Only selection process [...] the determined ones always change [...] (I3, 61, licensed nurse)

[…] Since we are CLT teachers, let us assume there are not classes for everyone. I am in tenth place, I am the last [...] If there is no class left, the contract is terminated [...] (I29, 53, nurse)

We have a rating for choosing an assignment. The more points I have, the higher up I am. I can choose the class and the time (I29, 53, nurse)

1b – Fixed-term contracts, service providers, and the division of labor among teachers

Both in the public network and, mainly, in the private network, a relationship between the employment relationship and the organization of pedagogical work at school is apprehended in the speeches, with a marked fragmentation between “theory” teachers and “internship” teachers. Some statements (I9 and I34) show the magnitude of this division even in quantitative terms. Speech I31 represents a conception that makes the teacher individually responsible for the risk of the work becoming a mere temporary job. In general, the precariousness of work relations was only observed. Only in speech 6 is there a certain questioning since there is no document that proves the insertion of a given professor in the internship activities:

[…] the professor will accompany the students during the internship […] does not issue any type of employment certificate […] (I6, 37, registered nurse)

[…] out of necessity, working with half the team practically CLT and during internships we rely on service providers (I9, 55, licensed in another area)

[…] the theoretical class is for those who are higher up […] I have no interest in theoretical classes […]. I like the practical part (I28, 27, nurse)

[…] When we look for an external professor to accompany the internship, some […] think that teaching is a side job, so this is bad […] I think that the professor who has this thought is bad […] the contract of these people is another […] are self-employed (I31, 55, licensed nurse)

Today we have an average of 10 CLT teachers, 40 in total, 30 service providers [...] (I34, 40, nurse)

1c – Remuneration per class hour

The statements below are representative of informality and payment per hour/class, both in private and public institutions, in this case in the ETSUS, considering their organization based on the inclusion of professionals from the Health Unic System as teachers.

We earn per lesson given. We do not have an employment relationship [...] we just pass on our data [...] (I14, 56, nurse)

He will be paid for hours/classes [...] he does not sign a contract (I20, 49, graduated in another professional field, with specializations in the health area)

It is easier for me to get a nurse from the institution and pay an extra hour [...] it is from the hospital [...] and we pay teaching hours [...] (I21, 57, nutritionist)

Category 2 – The intensification of work and the double journey

The statements below focus on the view of the interviewees regarding the insufficient number of teachers, the non-existence of workload for planning, and the need to work in more than one job, which leads to the consideration of overload:

[…] What has happened is that we have a very small group. (I6, 37, licensed nurse)

[…] there is a shortage of teachers […] there's little time for […] planning […] you end up having to work a lot off-site […] (I26, 40, pharmacist)

[…] Night shift teachers usually have another job […] I think everyone does (I21, 57, nutritionist)

Category 3 – From teacher to monitor

Teachers from a single private school refer to being hired as a monitor, not as a teacher, which they associate with teaching at EPTNM and the union to which they are necessarily linked. They note the situation but do not question it:

[…] I’m a Professional Education Monitor […] Our job is exactly the same […] it’s another union, there are other benefits, in short, the legislative part […] for the technical course, there is no requirement for a teacher [… ] when you have a teacher, you have more responsibilities [...] like [the school] essentially, it's a technical course, it would be very burdensome for the company [...] I don't know how to explain it to you (I22, 36, pharmacist)

[…] It is something educational, but it is not teaching […] I was never worried […] (I26, 40, pharmacist)

The physical facilities and other resources: what the visits and the thoughts of managers and teachers point out

In most institutions, the physical area is large (both public and private). Only in one of the private schools, which is the only one that solely offers the technical course in nursing, is there a smaller overall space (compared to the others). Probably, the physical area is also related to the number of courses offered and students enrolled. The schools belonging to the Centro Paula Souza are part of the São Paulo state network that offers high school and EPTNM courses in various technological axes. Two private institutions in the capital offer technical courses in the same physical area where undergraduate and graduate courses are offered. The schools belonging to the ETSUS function as headquarters since their courses are offered through decentralized classrooms. But these offices also offer technical courses and others for professionals, such as activities that are part of the health secretary. The Senac involved also has a wide offer of diverse courses in the same structure - open, technical, technical courses integrated into High School, EPTNM of various technological axes and specializations.

The classrooms are generally structured with a computer, video projector, internet access, and, in some places, a TV and digital whiteboard. In one of the public schools, the teacher needs to take his notebook, and one of the teachers considers the space insufficient. In private school that offers only the technical course in nursing, there are more restrictions, such as inadequate acoustics and the physical space, which, depending on the number of students in the class, is reduced. In two private schools in the capital in the same network, the classrooms have a specific acoustic treatment, carpeted floors, and a modernized design, probably incorporating care with aesthetics and comfort different from the others.

One of the relevant aspects at EPTNM concerns the need for laboratories that bring students closer to real work scenarios. In all participating schools that offer a technical course in nursing, there is at least one laboratory for teaching procedures that are part of care. During the visit, it was not possible to seek details regarding the equipment and materials of these laboratories, but it was possible to apprehend that in all schools, except one of the private ones, whose laboratory is quite deficient, there are low and medium fidelity mannequins. The size of the laboratories and equipment varies even within schools belonging to the same network (both public and private). A coordinator of a technical nursing course at a private school mentions that, despite the excellent structure of the laboratory, the number of students per class is high, considering the capacity of the place. Interviewees from a technical nursing course at the same public school point out both favorable aspects and limitations concerning the same laboratory, which also shows a relationship, probably, with other experiences and different expectations:

[…] we have a very well-equipped laboratory with constant replacement of materials […] several mannequins […] very good physical plant […] accommodates students well […] (I3, 61, registered nurse)

[…] we have a laboratory that needs reformulation […] exchange of materials […] it is a chronic problem (I18, 37, licensed nurse)

Still in the public sphere, interviewees from another school belonging to the same network as the school mentioned above point out, with satisfaction, the advances with the recent structural change of the nursing laboratory, which is specifying differences in each institution, probably not only in terms of resources (since they belong to the network with the same policy), but managed locally:

[…] Nursing laboratory, starting this semester […] it is very beautiful, spacious, equipped. But before [...] it was a very small laboratory, without a window [...] (I16, 42, nurse)

In schools where there are courses in nutrition and dietetics, pharmacy, and radiology, the specific laboratories were considered adequate by the interviewees, although one of the coordinators of a course at a public institution also focuses on some limitations:

[…] I feel that it is a very good infrastructure for the technical level […] they manipulate much more than I manipulated in college […] (I22, 36, pharmacist)

[...] The laboratory here is very complete [...] it is a hospital device, not a simulator [...] most of the equipment [...] is taken from the hospital, donated here to the university center [...] (I38, 37, medical radiology technologist)

[…] hot kitchen; complete bakery/confectionery and bar/restaurant with sufficient supplies [...] (I40, 45, nutritionist)

There is a peculiar situation related to teaching in the laboratory at a school that offers courses in decentralized classrooms, but it is evident that agreements with other institutions have helped:

[…] if I did not have an agreement with [the university] they would not have it […] how am I going to teach the student to aspirate a vial […] if I have nowhere to do it? […] (I11, 40, nurse)

[…] lack […] consumables […] Must have. It is a School of Nursing, right? […] (I23, 28, licensed nurse)

We manage to make good partnerships [...] with nearby universities [...] to use their laboratories [...] (I39, 50, educationalist)

In one of the private schools, the laboratory was mentioned by all the teachers interviewed as a significant limitation, with an inadequate physical structure that interferes with the organization of pedagogical work, with implications for training:

[...] it is very scrapped [...] then you keep teaching [...] here it is like this, but it cannot be any more [...] it is awfully bad to teach that way [...] (I14, 56, nurse)

A recurring problem in most schools concerns the conservation of equipment depending on whether or not there is a sufficient support structure. Some interviewees referred to the limitation imposed by the lack of a professional to take care of the laboratories, which also includes the idea that their maintenance and organization for moments of theoretical-practical activities are entirely the responsibility of the professor, which is questioned, as it is necessary to spend more time on unpaid work:

[...] I do not know any school [...] that the laboratory does not have a person who is responsible for it and here, financially, there is no condition [...] (I8, 55, nurse)

[...] could have a better investment, someone more technical [...] not the teacher having to go first to [...] arrange the laboratory [...] (I13, 43, nurse)

[…] there is no one in the laboratory […] I have to organize it […] it is not something I get paid for […] (I14, 56, nurse)

Only one school in the public network and another in the private network have a professional hired to support the laboratory. In another private school, there is the support of scholarship monitor students from the institution itself, and in a public unit, a teacher refers to a project that existed, including a teacher and a scholarship monitor student.

Schools offering undergraduate courses in other areas of health also have anatomy and multidisciplinary laboratories that can be used by students of technical courses. All schools also have a computer laboratory. In institutions offering technical courses involving information technology and others of the same technological axis, these spaces are well organized and can be used by students in the health area in formal moments of classes. As for their access to computers and the internet, in addition to class periods, there are huge variations between schools, but in all of them there is this possibility, however, with better conditions in private institutions, except in one of them: “The internet is very bad […] there is a lack of investment in the technological part” (I13, 43, nurse).

All schools have a library, but there are variations in physical space, collection, and organization. In schools in one of the public networks, the interviewees indicate limitations:

[…] [school] still does not have access to libraries and databases and journals […] (I18, 37, registered nurse)

Our library is scarce […] I give a lot of article references […] a book that I download in PDF (I25, 66, nurse)

Private schools that are part of a network have huge libraries and a policy of frequent collection renewal, especially those where undergraduate courses are also offered. However, it is not evident whether students have spaces in the activity schedule and sufficient guidelines for effective use of the library.

All schools have living spaces that even allow students to eat. The schools of Centro Paula Souza, which are part of the state network, have a cafeteria, and meals are served. Except for the private school that only offers the technical course in nursing, all other schools have some space where the student has access to a microwave oven, and there is a private school that provides a private resting area for students who are at school in the pre-class period. In all schools, except for the private institution that only offers a technical course in nursing, there is a collective room for teachers with access to a computer and the internet, with variations in the size of the physical area and equipment.

Regarding the structure and resources as a whole, it is essential to consider the diversities in terms of investments, which was also commented on in the interviews: in the ETSUS, there is no budget for professional education, with dependence on projects from the Ministry of Health or the state. In the participating private network, except in the institution with structural limitations, better investments are apprehended by the conditions presented.

Working conditions in the current neoliberal scenario and the implications for EPTNM in health

Considering the data indicated regarding the ways of hiring teachers at EPTNM in the health area, in previous historical moments, precarious relationships already existed (Bassinello & Silva, 2005 ; Frozoni & Souza, 2013 ). It is necessary, however, to focus on the contextualized reality in the scenario of changes in the world of work that has been taking shape since the 1990s in Brazil, to expand the extraction of overwork, strengthening precarious relationships to the detriment of social rights (Antunes, 2015 ). The historical origins of teaching work at EPTNM in the health area may even help in the naturalization of these relationships, which in the current scenario, tend to get worse.

These changes originate worldwide from the structural crisis of Taylorist-Fordist capitalism, which led to a broad movement of productive restructuring led by financial capital based on neoliberal ideas and intensified by digital technological advances. At the same time, structural unemployment is in process, which implies that more available workers are obliged to accept a job, regardless of their conditions, rights, and regulations. Thus, flexibility, informality, outsourcing, and intermittency are being expanded, including uberized work, whose expansion also involves, for example, doctors, nurses, and teachers (Antunes, 2022 ).

In Brazil, in the 1990s, legislation was enacted, such as the Fixed-Term Employment Contract Law 9601/98, regulated by Decree No. 2490/98 (Brazil, 1998 ; Finamor Neto, 2016 ), and the current labor reform in progress through Law No. 13.467/2017 (Brazil, 2017 ). It is worth highlighting the new public management as a development of neoliberal policies, focused on efficient results, operating by meritocratic logic, by privatization mechanisms of state-owned companies, including the installation of mercantile logic throughout the fabric of the public sphere (Silvia & Richter, 2022 ).

A study focused on one of the public networks also present in this study points out that the democratic management of public education, indicated in the current Federal Constitution, has been replaced by a management model arising from business administration, focusing on planning-executing-check-act. There is evidence of fragile democratic spaces and wide open to the participation of private agents interfering in curricular policies (Moraes et al., 2022 ).

The precariousness of work relations is present both in public and private networks. Despite the existence of CLT contracts in some private schools, through the interviews, it was possible to apprehend the existence of a lean CLT framework and the precarious hiring of many teachers, even considering the presence of schools with many classes of students. In the public sector, fixed-term contracts are present. It is associated with the accumulation of jobs, considering that the offer of courses at night is predominant, which has implications for the lives of teachers. And, as a public employee governed by the CLT, the attribution of classes based on a scoring system (São Paulo, 2015 ) that classifies teachers also shows the presence of instability.

A situation full of contradictions refers to working conditions at ETSUS. The purpose of training SUS workers has been of vital importance for strengthening the system and valuing workers. However, the organizational peculiarities of these schools, which operate through decentralized classrooms and with payment per hour/class, are limiting in terms of recognition of the teaching profession. Without denying that the performance of the professional inserted in the health service can contribute to the training of the technical worker, this action still needs to be better analyzed in the context of working conditions and teacher training, as there are implications that have been strengthening the fragility of professionalization.

In this direction, hiring teachers designated as monitors in one of the private schools also draws attention, which finds support in legislation that is no longer in force and in the current legislation on teacher training for the EPTNM that historically materialize fragile policies. Among those hired as monitors, there are graduated professionals and even those with a degree in the area. Therefore, a strategy is apprehended that is related to the disqualification of labor ties and remuneration. In this same direction of fragility, one must also consider the problem of notorious knowledge that has deleterious impacts on the professionalization of teaching work (Machado, 2021 ).

An aspect that must be considered is the logic (particularly in the private network) that service provider teachers will conduct the internship supervision. There is a notion that disarticulates theory and practice, which focuses on theory as what belongs to the classroom teacher and practice as something closer to professional doing. And this division associates differentiated formal employment relationships: CLT in the classroom and service providers in internships. The participants did not question this situation. This form of organization weakens the understanding of work based on praxis, understanding that between theory and practice: “[…] it is a matter of a difference - within an indissoluble unit. Therefore, one should speak, above all, of unity between theory and practice and, in this framework, of the autonomy and dependence of one to the other” (Vázquez, 2011 ). There is an emphasis in technical courses that have an internship concerning the importance of the so-called practical moments, but this distances itself from the meaning of work as an educational principle, based on the concept that work provides subsidies for the human being to develop productively, scientifically and culturally, returning to the subject the awareness of the implications of the social and technical divisions of the productive force in society.

Although it was not the focus of this text, the organization of pedagogical work in the scenario guided by precarious working conditions combined with fragile or even non-existent training predominant in EPTNM tends to strengthen the training of workers with a focus on the job market (Machado, 2021 ). The working conditions of teachers are inserted in the capitalist scenario and respond to the prevailing logic of flexible working relationships, both about the teaching practice itself and in the perspective of training the technical worker for the same logic. Kuenzer (2011 ) points out the flexible nature of the workforce, in which prior qualification matters less than adaptability, demanding disciplined subjectivities that align with dynamism, instability, and fluidity in work relationships.

The prevailing conditions in which teachers work in technical schools will have implications for the training of technical workers. The performance of many teachers through precarious formal employment relationships - which generates instability, double employment, overload, fragmented forms of organization of pedagogical work, and the experience, for some, of structural limits of the school - hinder collectively building a training project that advances in the direction of emancipation, which contributes to a solid ethical-political and technical formation.

The structural conditions of the schools, in general, are adequate considering normative indications (Brazil, 2020 a; São Paulo, 2022 a; 2022 b) in the minimum requirements that need to be inserted in the course plans and guaranteed, either in the institution itself or provided by another, such as the physical and technological infrastructure, including library, laboratories, and equipment. The current National Catalog of Technical Courses (Brazil, 2020 a), concerning the technical course in nursing, in addition to indicating a library, laboratory for procedures and information technology, advocates the existence of anatomy and physiology laboratories, which is only found in this study in schools that operate in the same space where graduations in the health area are offered (Brazil, 2020 b; São Paulo, 2022 a; 2022 b). The same document (Brazil, 2020 a) also indicates, in addition to the elemental spaces mentioned, for the pharmacy technician course, the observance of chemistry and microbiology laboratories, and, for the nutrition and dietetics technical course, the anatomy laboratory (also not present in the schools visited). Laboratories are essential pedagogical spaces in training in the health area, including EPTNM. It appears that, in one of the private schools, the inadequacy of this space implies concerns and dissatisfactions on the part of teachers, with probable limiting repercussions on the training process.

While observing the physical structure and the interviewees' speeches, it is possible to apprehend diversities in investments, with higher limitations for the public sphere but also in the private sector. As learned in the interviews, one of the schools that only offer technical education in nursing has evident structural difficulties that impact the pedagogical work and training. This school is not part of any broad network with a strong supporter in the market, which is observed in the other private institutions. In particular, in recent years, the ETSUS, given the policy based on the prevailing neoliberal ideals, has faced underfunding by the federal government or state and municipal management bodies (Bonfim et al., 2017 ).

One crucial point is to take the physical conditions, including equipment and other resources, as a sine qua non condition so that the training process can occur effectively and without wearing out the teachers. However, they cannot be seen in themselves without reference to a purpose as far as such conditions are instruments that can serve diverse education and society projects. Thus, limitations emerged on public investments in the ETSUS, whose training project could contribute to maintaining and strengthening the SUS with social impact. At the same time, investments in the structure of schools in the private network are noticeable, which have as their purpose the explicit training for the labor market and, even more, to increase the training of workers for hospital networks that belong to the same maintainer, in the privatized health scenario.

The relationship between investments and the private network cannot be generalized, as this study also brought up schools with less structural investments and precarious training spaces, with probable difficulty even in guaranteeing adequate training in its elemental technical dimension. In the same way, there is still a public-school network that presents some limitations, but less aggravated as in the previously commented private school. However, it has in its organization impacting private influence in the management and curriculum definition, as commented throughout the text.


The precariousness of labor relations in public and private networks stands out. Given the participating managers, the CLT's formal employment relations for an indefinite period are predominant. However, as for teachers, there is diversity with the CLT for indefinite and fixed-term contracts, service providers, and even the absence of a formal employment relationship. Some participants have more than one job, including, more specifically, professors who are also business owners, showing the movement towards entrepreneurship, which can be understood as the search for better living conditions, however, strengthening the sector privatization of health and education. There is a reference to work overload and, on one of the private networks, the mention of hiring a teacher as a monitor.

It is understood, therefore, the predominance of commitments of most participating schools to maintaining the social relations in force in the capitalist production mode. In this scenario, working conditions respond to the logic of flexible relationships, both in terms of teaching and the perspective of training technical workers for the same logic, distanced from emancipatory training. Critically analyzing and collectively confronting this logic demands differentiated teacher training, which is a challenge given the weaknesses of public teacher training policies for the EPTNM.

As for the physical structure and other resources, some limitations in public schools, especially in ETSUS, are evident in the speeches and visits. Investments in schools belonging to large private networks are considerable. There are also private schools with structural limitations that tend to hinder training. The physical structure and resources must be considered concerning the training proposal of the courses that can be at the service of diverse education and society projects.

Some limits can be pointed out without disqualifying the scope of this study: despite several attempts, it was not possible to access other private schools that offer many courses and empirically has an idea of their structural limits. There was no adhesion of professors of the technical course in radiology to the interviews.


Antunes, R. (2015). Adeus ao trabalho? Ensaio sobre as metamorfoses e a centralidade do mundo do trabalho. Cortez. [ Links ]

Antunes, R. (2022). Capitalismo pandêmico. Boitempo Editorial. [ Links ]

Bardin, L. (2016). Análise de conteúdo. Setenta Edições. [ Links ]

Bassinello, G. A. H., & Silva, E. M. (2005). Profile of nursing teachers engaged in secondary school's professional education. Revista Enfermagem, 1, 76-82. ]

Bonfim, M. I., Rummert, M. R., & Goulart, M. G. (2017). Educação profissional em saúde: o sentido da escola pública e democrática. Revista Cocar, 11 (21), 322-343. ]

Brasil. (1998). Lei 9.601 de 21 de janeiro de 1998. Dispõe sobre o contrato de trabalho por prazo determinado e dá outras providências. Presidência da República. Congresso Nacional. ]

Brasil. (2017). Lei n.º 13.467 [Altera a Consolidação das Leis do Trabalho]. Presidência da República. Secretária-geral. ]

Brasil. (2020a). Catálogo Nacional dos Cursos Técnicos. Ministério da Educação. ]

Brasil. (2020b). Parecer Conselho Nacional de Educação e Conselho de Professores (CNE/CP) N.º: 17/2020. Ministério da Educação. ]

Caires, V. G., & Oliveira, M. A. M. (2016). Educação profissional brasileira: da colônia ao Plano Nacional de Educação (PNE) 2014-2024. Vozes. [ Links ]

Cellard, A. (2012). A análise documental. Em J. Poupart et al. A pesquisa qualitativa: enfoques epistemológicos e metodológicos (pp. 295-316). Vozes. [ Links ]

Corrêa, A. K., Souza, M. C. B. M., & Clapis, M. J. (2022). Oferta de cursos e instituições de formação de técnicos em saúde no estado de São Paulo. Revista Brasileira de Educação Profissional e Tecnológica, 1(22), e11787. ]

Finamor Neto, J. G. (2016). A precarização do trabalho docente na rede estadual de educação do Rio Grande do Sul: um estudo sobre a situação das professoras com contrato de trabalho temporário na zona norte de Porto Alegre. [Dissertação de mestrado, Universidade Federal do Rio Grande do Sul]. ]

Frozoni, R. C., & Souza, M. C. B. (2013). Educação profissional técnica de nível médio em enfermagem: perfil sócio econômico dos professores de um município do estado de São Paulo. Revista Eletrônica Gestão & Saúde, edição especial, 1680-1693. ]

Kosic, K. (1976). Dialética do concreto. Paz e terra. [ Links ]

Kuenzer, A. Z. (2011). EM e EP na produção flexível: a dualidade invertida. Revista Retratos da Escola, 5(8), 43-55. ]

Machado, L. R. S. (2021). Políticas de formação de professores: notório saber e possibilidades emancipatórias. Revista Retratos da Escola, 15(31), 51-64. ]

Moraes, C. S. V., Reis, E. D., & Alencar, F. (2022). Educação profissional paulista e relações público-privadas na política curricular: Centro “Paula Souza” (1995-2018). Revista Brasileira de Educação, 27, e270005. Links ]

Moura, D. (2014). Trabalho e formação docente na educação profissional. Instituto Federal do Paraná. ]

Oliveira, D. A. (2010). Condições de trabalho docente. Dicionário de verbetes. ]

Organização Pan-Americana da Saúde (OPAS). (2021). Principais estatísticas sobre a força de trabalho de enfermagem nas Américas (perfis dos países). ]

Romanelli, O. O. (2012). História da educação no Brasil (1930/1973). Vozes. [ Links ]

São Paulo. (2015). Deliberação do Conselho Deliberativo do Centro Estadual de Educação Tecnológica Paula Souza - (CEETEPS) - N.º 23. Centro Paula Souza. ]

São Paulo. (2022a). Deliberação 207/2022. Conselho Estadual de Educação (CEE). ]

São Paulo. (2022b). Indicação N.º 215/2022. Conselho Estadual de Educação (CEE). ]

Silvia, M. V., & Richter, L. M. (2022). A adoção da nova gestão pública nas agendas governamentais em diferentes países: influências nas reformas educacionais e no ensino médio mineiro. Revista on line de Política e Gestão Educacional, 22(3), 1276-1296. ]

Vázquez, A. S. (2011). Filosofia da práxis. Expressão Popular. [ Links ]

Wermelinger, M. C. D. M. W., Boanafina, A., Machado, M. H., Vieira, M., Ximenes Neto, F. R. G., & Lacerda, W. F. D. (2020). A formação do técnico em enfermagem: perfil de qualificação. Ciência & Saúde Coletiva, 25(1), 67-78. ]

Received: December 24, 2022; Accepted: March 31, 2023

Contribution to the preparation of the text

Author 1 – conception and coordination of the research development, application of interviews/questionnaires, and on-site visits, data analysis; writing and revision of the final manuscript. Author 2 – support in the research development, systematization and analysis of quantitative data, and manuscript revision. Author 3 – support in the research development, participation in on-site visits and data systematization, and manuscript revision.

Creative Commons License Esta obra está licenciada sob uma Licença Creative Commons CC BY 4.0.